G0444 is one of the most under-billed codes in primary care and one of the most casually over-billed in behavioral health. Both errors come from the same misunderstanding: it is a screening code, and screening means looking for a problem in someone who has not presented with one.
What HCPCS G0444 covers
G0444 is Medicare's annual depression screening. CMS's short descriptor in the fee schedule file is "Depression screen annual". It is a HCPCS Level II code, not a CPT code, and it exists because Medicare created a payable service for a preventive screening the U.S. Preventive Services Task Force recommends at grade B.
Two companion codes cover alcohol misuse and follow the same logic:
- G0442: annual alcohol misuse screening.
- G0443: brief face-to-face behavioral counselling for alcohol misuse, 15 minutes, for patients who screen positive.
The coverage criteria that decide the claim
Depression screening is covered under National Coverage Determination 210.9, effective October 14, 2011, and the conditions are narrower than most practices realise.
- Annual. Once per 12-month period, with eleven full months elapsing after the month of the last screening.
- Primary care setting. Coverage attaches to screening delivered in a primary care setting, not to the act of screening wherever it happens.
- Staff-assisted depression care supports must be in place. At minimum that means clinical staff in the primary care setting who can advise the physician of screening results and who can facilitate and coordinate referrals to mental health treatment. A setting without those supports does not meet the NCD.
- Any validated tool. CMS does not name a screening instrument and leaves the choice to the clinician.
Alcohol misuse screening sits under NCD 210.8 on the same pattern: G0442 once per 12 months, and for patients who screen positive and are competent and alert at the time of counselling, up to four G0443 sessions in a 12-month period.
Because these are recommended preventive services, Medicare waives the coinsurance and the deductible when the coverage criteria are met. That makes them unusually easy to offer and unusually easy to forget to bill.
Screening means the patient is not already symptomatic
This is the rule that catches behavioral health practices, and NCCI states it with an example that uses this exact code. If an evaluation and management, medicine, psychiatric diagnostic or psychotherapy service is related to a problem that would normally require evaluation duplicative of the HCPCS code, the HCPCS code is not separately reportable. The manual's own illustration: if a patient presents with symptoms suggestive of depression, the provider shall not report G0444 in addition to that service.
So the test is not "did we administer a PHQ-9". It is whether the screening was distinct in time and work from the evaluation that was already happening. A patient arriving at a psychiatric practice for depression is not being screened for depression. A patient arriving for a wellness visit is.
Documentation requirements
- The instrument used and the score. A note saying "depression screening performed" without a result is not defensible.
- The date of the last screening, or confirmation that none falls inside the 12-month window.
- A follow-up plan for a positive result. This is the part of the NCD that makes the service a programme rather than a questionnaire.
- Evidence that staff-assisted supports exist, at practice level rather than per patient.
- Separate time and work from any other service billed that day, recorded as such.
- For G0443, the session content and duration, and the count of sessions used in the 12-month period.
Common denials and the exact fix
Frequency: a second screening inside 12 months
The most common G0444 and G0442 denial, and usually a tracking failure rather than a clinical one.
Fix: track the last screening date per patient and require eleven full months to have elapsed. Annual wellness visits drifting earlier each year are a frequent cause.
Billed for a patient already being treated for depression
The patient presented with the condition, so the work is evaluation rather than screening.
Fix: reserve G0444 for screening an asymptomatic patient. Where depression is the reason for the visit, the evaluation code carries the work.
Same-day E/M denied, or the screening denied against it
The pair is allowed with a modifier, so the failure is usually a missing one.
Fix: append modifier 25 to the E/M, not to G0444, and make sure the record shows the screening's time and work were separate.
Setting does not meet the NCD
Screening billed from a setting without staff-assisted depression care supports.
Fix: confirm the setting qualifies before building the service into a workflow. This is a practice-level decision, not a per-claim one.
G0442 billed with G0396 or G0397
Alcohol screening billed alongside a structured assessment and intervention for the same encounter.
Fix: the pair carries indicator 0 and is flagged mutually exclusive. Bill the one that matches the service actually delivered.
More than four G0443 sessions in 12 months
Counselling continues past the covered allowance.
Fix: count sessions per rolling 12 months per patient, and move to an appropriate treatment code once the allowance is exhausted.
Modifier rules
- 25: on the E/M, where a separately identifiable evaluation happened alongside the screening. Never on G0444 itself.
- 59, XE, XP, XS, XU: for genuinely distinct services where the edit permits a modifier.
- 95 or 93: telehealth, where the payer allows these services remotely. Confirm first, because preventive screening rules and telehealth rules do not always align.
- No 26 or TC: PC/TC indicator 0 for all three codes.
- These are preventive services, so no advance beneficiary notice modifier applies when the criteria are met. Where the criteria are not met, the service is simply not covered.
NCCI bundling edits
From the Medicare practitioner procedure-to-procedure file effective October 1, 2026. Indicator 1 means a modifier may release the pair when the services were genuinely distinct; indicator 0 means none will.
- 99202 to 99215 with G0444: indicator 1, rationale "more extensive procedure". Modifier 25 on the E/M, plus a record showing separate time and work.
- The psychotherapy and evaluation codes with G0444: indicator 1 across 90791, 90792, 90832 to 90840, 90845 to 90853, 90865 and 90880.
- G0444 with 96127: indicator 1. The brief emotional and behavioral assessment and the annual depression screening are different services and need to be documented as such.
- G0442 with G0396 or G0397: indicator 0, mutually exclusive.
- G0443 with G0396 or G0397: indicator 0, "more extensive procedure".
- G0442 or G0443 with 99408 or 99409: indicator 0. Those two CPT codes are non-covered by Medicare in any case.
- G0442 or G0443 with 96156, 96158, 96164 or 96167: indicator 0.
- G0442 or G0443 with 96127: indicator 0.
What HCPCS G0444 pays
All three codes are low-value individually and meaningful only at volume, which is exactly why they are worth automating rather than remembering. Medicare publishes relative values rather than a price.
2026 Medicare RVUs for HCPCS G0444
| HCPCS G0444: 2026 Medicare RVUs (national, before GPCI) | ||||||
|---|---|---|---|---|---|---|
| Line | Work | PE, non-facility | PE, facility | Malpractice | Total, non-facility | Total, facility |
| Global (no modifier) | 0.18 | 0.37 | 0.05 | 0.01 | 0.56 | 0.24 |
Source: CMS CY 2026 PFS Relative Value File, RVU26D (October release, published 08/26/2026). RVUs are national and unadjusted; commercial and Medicaid payers set their own rates and their own coverage.
In the 2026 CMS relative value file, HCPCS G0444 carries 0.18 work RVUs, with 0.56 total RVUs in a non-facility setting and 0.24 in a facility. The gap is practice expense: in an office the practice carries it, in a facility the facility does. Its PC/TC indicator is 0: CMS treats it as a physician service, so modifiers 26 and TC do not apply to it in any setting. Its global indicator is XXX: the surgical global period concept does not apply, so there is no postoperative period bundling other services into it.
Units per day. Medicare's medically unlikely edit allows 1 unit of HCPCS G0444 per patient per day (a date of service edit set by policy, rationale: CMS policy). A second unit on the same date will not pay. MUE values are published quarterly in the Medicare NCCI practitioner services MUE table; the value above is from the table effective October 1, 2026.
To turn RVUs into payment, each component is multiplied by your locality's geographic practice cost index, the three are added, and the sum is multiplied by the 2026 conversion factor: $33.4009, or $33.5675 for qualifying APM participants (CMS-1832-F; CMS fact sheet). The CMS Physician Fee Schedule Look-Up Tool runs that calculation for your own locality.
Frequently asked questions
How often can HCPCS G0444 be billed?
Can G0444 be billed for a patient already diagnosed with depression?
What are the coverage requirements for Medicare depression screening?
Can G0444 be billed with an office visit on the same day?
What is the difference between G0442, G0443 and G0396?
Sources
American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, CY 2026 PFS Relative Value File RVU26D (October release, published 08/26/2026): RVUs, PFS status indicator, PC/TC indicator and global indicator for G0444.
Centers for Medicare & Medicaid Services, CY 2026 Physician Fee Schedule final rule, CMS-1832-F: conversion factors.
Centers for Medicare & Medicaid Services, Medicare NCCI Practitioner Services medically unlikely edit table, effective October 1, 2026.
Centers for Medicare & Medicaid Services, Medicare NCCI procedure-to-procedure edits for practitioner services, 2026 Q4 file effective October 1, 2026.
Centers for Medicare & Medicaid Services, National Coverage Determination 210.9, Screening for Depression in Adults (effective October 14, 2011): the annual frequency, the primary care setting requirement and the staff-assisted depression care supports condition.
Centers for Medicare & Medicaid Services, National Coverage Determination 210.8, Screening for and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse: the annual screening and the counselling session allowance.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual for Medicare Services, revision date 1/1/2026, Chapter XI, on when a screening HCPCS code is not separately reportable alongside an evaluation.
CPT® is a registered trademark of the American Medical Association. Payer policy, NCCI edits and MUE values change quarterly, so check your own contractor and your commercial contracts before submission. How we verify this guidance.
Related codes
- CPT 90791. The diagnostic evaluation, which absorbs the screening work when the patient is already symptomatic.
- CPT 90792. The prescriber's evaluation, paired with these screening codes at indicator 1.
- CPT 99492. Collaborative care, the model a positive screen is often referred into.
Related reading
- Behavioral health & psychiatric billing. How we scrub session-based claims, track prior authorization and bill collaborative care.
- 2026 behavioral health code changes. What the CY 2026 fee schedule changed for collaborative care, digital mental health and telehealth.
- Provider credentialing & payer enrollment. A behavioral health claim only pays in network once the clinician is enrolled and effective.
- Behavioral health prior authorization in 2026. Why authorizations lapse mid-episode and what catching them early is worth.
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